Health Care Costs
http://thedianerehmshow.org/shows/2011-06-30/health-care-costs
Health care costs in this country are on an unsustainable trajectory: Years of percentage increases are crushing family, corporate and government budgets. Many elements included in last year’s Affordable Care Act are intended to reduce the rate of increase, but even if all goes according to plan, costs are likely to continue to rise. Health care experts join us to talk about some of the many factors driving costs ever upward such as our fee for service model, chronic disease management, and an overall lack of transparency. Join us to discuss health care costs ...and what needs to change.
Guests
Dr. John Wennberg
founding director, Dartmouth Institute for Health Policy and Clinical Practice and author of "Tracking Medicine: A Researcher's Quest To Understand Health Care"
Daniel Callahan
senior research scholar and president emeritus, The Hasting Center and author of "Taming the Beloved Beast: How Medical Technology Costs Are Destroying Our Health Care System"
Karen Ignani
president and CEO, America's Health Insurance Plans
Comments
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I am SO glad that you are covering this topic today. I was reading the NHEA report a couple of days ago and the costs for health care are amazing. What was surprising to me as well was the concentration of the population who is driving up those costs:http://michaelmaczesty.blogspot.com/2011/06/5-of-americans-hogging-health-care.html
(disclosure: I am a member of a romneycare plan in massachusetts, and I support healthcare reform in this country.)
Because healthcare providers live in a bubble economy -- by which I mean that providers receive massive amounts of money without regard to actual performance, much like defense, the 80's dotcom industry, the 00's housing market -- healthcare costs will never come under control the way things are currently structured or proposed. The current Obamacare / Romeneycare design only magnifies this problem as it amounts to an entirely new revenue stream for the healthcare providers, who will simply raise prices and feast on this windfall.
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My 84 year old mother just went through a knee replacement surgery. I tended to her after the surgery and for weeks after. Was closely aware of all of her therapy etc. As I went through her bill charged to medicare by private therapist etc. I found a suspicious 900.oo bill for two hours of therapy. The correct charge was 320.oo
Then there were the cost of four different visits for one half hour each to private therapists at 400.oo for each visit. Total of 1600.oo for 2 hours of therapy. Outrageous! So much fraud.
When I called Medicare they were barely interested in filing a complaint. If people were to go over their medical bills with fine tooth combs...that would be a start.
Do nurses and in house employees of any institutions give rewards for turning in fraudulent claims?
My 84 year old mother just went through a knee replacement surgery. I tended to her after the surgery and for weeks after. Was closely aware of all of her therapy etc. As I went through her bill charged to medicare by private therapist etc. I found a suspicious 900.oo bill for two hours of therapy. The correct charge was 320.oo
Then there were the cost of four different visits for one half hour each to private therapists at 400.oo for each visit. Total of 1600.oo for 2 hours of therapy. Outrageous! So much fraud.
When I called Medicare they were barely interested in filing a complaint. If people were to go over their medical bills with fine tooth combs...that would be a start.
Do nurses and in house employees of any institutions give rewards for turning in fraudulent claims?
My 84 year old mother just went through a knee replacement surgery. I tended to her after the surgery and for weeks after. Was closely aware of all of her therapy etc. As I went through her bill charged to medicare by private therapist etc. I found a suspicious 900.oo bill for two hours of therapy. The correct charge was 320.oo
Then there were the cost of four different visits for one half hour each to private therapists at 400.oo for each visit. Total of 1600.oo for 2 hours of therapy. Outrageous! So much fraud.
When I called Medicare they were barely interested in filing a complaint. If people were to go over their medical bills with fine tooth combs...that would be a start.
Do nurses and in house employees of any institutions give rewards for turning in fraudulent claims?
Medicare is far more efficient than private sector based health care. It is hobbled by the fact it cannot negotiate drug costs.
The private insurance companies have overhead of order of 25%. Compare this to 4% in France.
Obviously we need to redo our health care from ground up and the private insurance companies may be part of a problem, but do not seem to be part of solution.
They are good at lobbing politicians from our poor and backward southern states, which are working against interest of their own populations.
Except for medicare and VA, we pay more for less than any other advanced country.
Is there any safe and efficient way to turn individuals who have and are committing medicare fraud in? Are there ways for nurses and in house employees of private institutions who are committing medicare fraud into appropriate authorities to be investigated?
I know of very wealthy individuals who have knowingly committed serious and costly medicare fraud. Extremely costly to taxpayers.
It's funny how the country spent over a year debating health cost issues and finally coming up with "Obamacare," but with health costs still unresolved. Obamacare focused mainly on insurance coverage and not on cost control. Obama's administration discussed all these cost problems, but seemed to do little about controlling them (except maybe starting some pilot programs).
Could someone talk about the insane overhead generated by our healthcare providers?
Somebody needs to bring Medicare mill operators to account. I know of a marginally competent Hickory, NC GP in financial crisis. He has contracted to provide care at several retirement homes. He routinely prescribes without adequate testing for patients he has never met. Recently I've come across several residents who were given massive doses of Lasix and support hose when their actual malady was cellulitis, a dangerous skin infection. (this was in the course of my video documentary work.) I find other indications of mass mis-treatment without examination as if a herd of cows were being given their routine meds. And yet this "doctor" bills as if he's seen each individual when the only contact may be word of mouth through a CNA, as his private practice is 50 miles from some of the homes. If anyone has a loved one in nursing or assisted care you should check behind these profiteers. (Especially in the Hickory-Charlotte corridor)
I do have sympathy for the doctor mentioned. He looks haggard and takes Prozac (staff leak, casual encounter). If the medical system is so destructive of providers how could any of them resist our trying for a simpler single payer system with less confusion and overhead? My own PC doctor near Princeton, NJ recently went on disability after an attempted suicide and returned to paint and read at his mother's home in another state. I am not a physician but it is a sick profession where only the monsters thrive.
RE: Avastin pulled by FDA for breast cancer indication only
"The day after a panel of experts advised the Food and Drug Administration to go ahead with plans to revoke approval of Avastin to treat breast cancer, European authorities moved in the opposite direction. The European Commission gave the OK to an expansion of Avastin's approval to include using the drug in combination with Xeloda, a chemotherapy drug, to treat metastatic breast cancer, Genentech parent company Roche said Thursday.
The Europeans considered the same information that hasn't proved persuasive to U.S. regulators. Among other things, a study called RIBBON 1 found Avastin plus Xeloda increased progression-free survival of women by 2.9 months over women getting Xeloda alone."
Obama death panel at work. Women with breast cancer will have to go to Europe to get cutting-edge care apparently.
Quoting studies from the 70s, really?
Malpractice problem is a urban legend propagated by insurance industry. This is quote from T"the Medical Malpractice Myth (Tom Baker)"
"What the medical societies did not tell my father, or almost anyone else, was that their own research showed that the real problem was too much medical malpractice, not too much litigation. In the mid-1970s the California Hospital and Medical Associations sponsored a study on medical malpractice that they expected would support their tort reform efforts. But, to their surprise and dismay, the study showed that medical malpractice injured tens of thousands of people every year—more than automobile and workplace accidents. The study also showed that, despite the rhetoric, most of the victims did not sue. But almost nobody heard about the study because the associations decided that these facts conflicted with their tort reform message."
Thanks for this topic, I operate a assistive technology and medical equipment library in Syracuse New york, TRAID center and Project Adapt. We exist for the general public to use and re-use equipment. find the best fit etc... the costs of Durable Medical Equipment are absurd as is the rules and does not include devices that are used are not allowed to be returned. "classic example of the power wheel chair that is ordered and can't get in the door?? that's 10-15,000 down the drain can't be returned?? or Computers that are so outrageous regarding $$ and don't last or just not effective enough. Are we looking at Durable Medical equipment and assistive technology regarding costs and reimbursements??
Yes kathleen, whistleblowing house employees are rewarded for snitching: They get canned, just like in the federal government. Some may pay damages or serve time. In medicine framing up is easy. All it takes is coerced perjury.
Hainc - President has nothing to do with FDA drug approval process. Get your facts straight.
The core problem I see in this country when it comes to healthcare is our stubborn belief:
As a youngster we refuse to seek healthcare.
As an adult we consume and practice unhealthy eating habits and at the same time do not exercise.
As a senior adult we refuse to have our family members care for us but expect the government to care and pay for all of our health issues.
I have spent the last three and a half years in nursing homes and assisted living facilities with my 86 year old WW II veteran father. Became so interested in what is going on in mostly privately owned nursing homes that I have been into around 20 around the Dayton Ohio region. The average price per bed in Ohio is around 6000.oo. Some of these facilities provide excellent care....some not so much
Most of our seniors in these places pay these bills through a combination of their pensions, social security etc. The majority of individuals bills are partially paid by medicaid. A large portion of the individuals bills are paid completely by medicaid. Someone is making millions if not billions off of these charges to government funded health care...and believe me it is not the nurses aides who make pathetic wages.
Can your guest please discuss pharmaceutical and bed cost in these mostly private nursing homes to our nations health care cost
right, he names the head of it, determines it's budget and priorites...
maybe your view was true in the 70s, like malpractice, but now not so much
how naive
One of your guest just mentioned that the "denial of death" is costly and that individuals facing death should be admitted into hospice services much earlier. What percentage of an individuals health care cost are spent in the last weeks of their lives? I have read it is about 95%
Actually, there is a significant amount of the health reform law (AKA "Obamacare") devoted to innovative cost containment initiatives, many of which are still in introductory or even planning phases. This helps to explain why so many in the public are not aware of these provisions. The full timeline for reform implementation stretches to 2018, which I think is sensible in light of the degree of change we are hoping to make; it would be disruptive and impractical to introduce all at once.
Good 'health' care killed both my parents in Florida(2000 n 2008 and my grandmother in late 70's).
I had 'good' health care in NC with four active prescriptions. For pain and suffering(stress). Three of my presciptions recalled(substitute for pain) which did wonders for the stress.
USPS helped by firing me(not accepting paperwork due to timing... when ill did not meet deadlines...). Also did wonders for stress.
Believe I had stroke... very difficult to do paperwork or read when I used to read a few books per week.
Now with VA have zero prescriptions and a mostly non English speaking doctor... who I am afraid we bombed his village- it would explain a lot.
High tech worker... foreclosure... unemployavble owing IRS's!!! Six year active duty, 13 years USPS, one year contractor for military.
Young construction worker also for seven years. Worked two jobs then... the thought that I have to work a nonexistant job for the next twenty years RIDICULOUS.
But willinig to work which makes me non disabled as well. THIS month the $200 for food needs to include extra week due to budgets cuts...
Go Congress as I will not be able to make it past the Holiday weekend... neighbor and his GF military widow(Iraq)... moving back to Moms as his $400 for 40 percent disability NOT paying the bills...
Good work- many other comments but my time short- keep up the work- the economy needs YOU !
Ex-wife has donated kidney BUT no guarantee of anti-rejection drugs if needed.
Where is OUR 'bailout'. Better YET put me to work(again) making this a better built country!
Provide the care, pay the 'extra' cost from ALL the savings. The humane thing to do. The religious thing to do(ease suffering).
Imagine the ROI ! I know, it is the pain/stress talking.
Happier workers, patients and better results.
Well thanks for allowing the 'venting'.
Can you spare a cup of coffee?
Why does no one ever discuss the impact that insurance companies have on the cost malpractice? I am a lawyer and wrote a paper on tort reform in law school and was surprised to discover that the worst case a plaintiff's attorney can take in front of a jury is for medical malpractice. The fact is that juries are made up of people and people generally trust their doctors. The percentage of cases where a jury finds against the doctor is in the single digits and yet insurance companies would rather settle with the plaintiff - and raise the doctors' premiums - than defend the doctor in court. And the doctor has no say in the matter. So a doctor who is in a high risk field like ob/gyn and anesthesiology may get sued more often than others, and have done nothing wrong, but the insurance companies will not let them defend themselves and instead offer a settlement to the patient and increase the cost of that doctor's malpractice insurance when he or she may have done absolutely nothing wrong.
Why do Doctors give a prognosis when a very elderly patient is concerned. When my Mother-in-law was 98 and declining, but she could still talk to us and walk a little. She got pneumonia, all the Dr. said was do we want to treat the disease. This was our first time in being caregivers for an elderly person and we did not know to ask this question. They cured the pneumonia but she was blind (had been going blind before) and now deaf and bedridden for the last 2 years of her life. She had been a beautiful vibrant woman well into her 80's and we felt awful to have made this decision that prolonged her death in such a manner.
The same book quote:
"Products liability and medical malpractice insurance look even less significant compared to what ordinary Americans paid for personal auto liability and no-fault auto insurance: $115.5 billion in 2003. That is more than U.S. business paid for auto, workers’ compensation, products liability, and medical malpractice insurance combined. Adding all the premiums of all the different kinds of liability insurance together results in a big number—about $215 billion in 2003—but that number is hardly exploding, and the medical malpractice insurance share—$11 billion—looks pretty small by comparison. It looks even smaller next to the $1.5 trillion plus (that is more than 1,500 billion dollars) we spent on health care that year. Something that amounts to less than 1 percent of health-care costs simply cannot have the impact on health care that the medical malpractice myth would have us believe."
I am so grateful to President Obama for pushing Health Care Reform. It's not perfect, but it is a start in the right direction. My belief is that a person's health should not be in the hands of private corporations whose main motive is PROFIT.
My personal experience with United Health Care was a good example...
1. UHC took over the smaller health insurance company I was with.
2. UHC then jacked up my premiums from $150 to $370 within 2 years.
3. UHC then, in 2001, decided to discontinue individual policies because "they were not profitable." So, I (and 7500 Arizonans) were left to find other insurance.
4. No luck. As a breast cancer survivor I was deemed UNINSUREABLE by every other private insurance company.
I spent 3 nervous years uninsured until I reached 65. Now, Republicans want to dump Medicare and start a VOUCHER system. Give us a break!!!!
Yes the OPUS has no effect on that level of federal government. Just like Congress. Sorry but when the OPUS sneezes we all get a chill.
I am always surprised in discussions of US healthcare costs that there is so little information given about how other countries deliver much better healthcare for lower cost.
Why don't we look at the best value healthcare delivery system in the world and see how we can move to mimic it?
We always seem to talk about what tweaks we can make to our very disfunctional and wasteful system when there are many examples in other countries that are much cheaper and better.
When people truely understand what level of healthcare they could have for a significantly lower cost they will begin to make the politicians advocate for serious change.
There are tens of thousands of seniors being kept alive and doped up on pharmaceuticals sitting in front of TV.s in nursing homes across the nation. Now granted the determination of a persons quality of life is individual and family related. People are always talking about how we should not "play god" when it comes to abortions yet support the medical system "playing god" at the end of a persons life. How much is not talking about end of life choices driven by pharmeceuticals and other industries that profit off of keeping people alive at any cost? We are talking about their profit margins here.
As part of preventative check up, a less than 5min nurse given hearing test was billed for $31 (~$350/hr) Insurance would not pay for this hearing test although all preventative visit are covered 100% in my plan. The Employee's Company had opted out for this hearing test and did not distributed this information.
Secondly, my 12 years old son's toe was treated for a wart. During a preventative visit the ~ 10min wart removal was billed as laser surgery @$300. I check with insurance Co. that it was billed correctly from the general physician .
Thus, I have come not to trust our medical and our insurance industry. First these prices are ridiculous and secondly the billing language leaves not knowing if it was billed honestly.
Luckily we are healthy family and do not go to the doctor I believe because we eat a whole foods based healthy diet and keep our weight normal. I feel the best insurance you could have is to keep yourself healthy and not use the medical system. If something is wrong change your habits and keep a diary about foods and behaviours to diagnose yourself.